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Afonso AM, Cadwell JB, Staffa SJ, Sinskey JL, Vinson AE. U.S. Attending Anesthesiologist Burnout in the Postpandemic Era. Anesthesiology 2024; 140:38-51. [PMID: 37930155 PMCID: PMC10751072 DOI: 10.1097/aln.0000000000004784] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
BACKGROUND Anesthesiologists are experiencing unprecedented levels of workplace stress and staffing shortages. This analysis aims to assess how U.S. attending anesthesiologist burnout changed since the onset of the COVID-19 pandemic and target well-being efforts. METHODS The authors surveyed the American Society of Anesthesiologists' U.S. attending anesthesiologist members in November 2022. Burnout was assessed using the Maslach Burnout Inventory Human Services Survey with additional questions relating to workplace and demographic factors. Burnout was categorized as high risk for burnout (exhibiting emotional exhaustion and/or depersonalization) or burnout syndrome (demonstrating all three burnout dimensions concurrently). The association of burnout with U.S. attending anesthesiologist retention plans was analyzed, and associated factors were identified. RESULTS Of 24,680 individuals contacted, 2,698 (10.9%) completed the survey, with 67.7% (1,827 of 2,698) at high risk for burnout and 18.9% (510 of 2,698) with burnout syndrome. Most (78.4%, n = 2,115) respondents have experienced recent staffing shortages, and many (36.0%, n = 970) were likely to leave their job within the next 2 yr. Those likely to leave their job in the next 2 yr had higher prevalence of high risk for burnout (78.5% [760 of 970] vs. 55.7% [651 of 1,169], P < 0.001) and burnout syndrome (24.3% [236 of 970] vs. 13.3% [156 of 1,169], P < 0.001) compared to those unlikely to leave. On multivariable analysis, perceived lack of support at work (odds ratio, 9.2; 95% CI, 7.0 to 12.1), and staffing shortages (odds ratio, 1.96; 95% CI, 1.57 to 2.43) were most strongly associated with high risk for burnout. Perceived lack of support at work (odds ratio, 6.3; 95% CI, 3.81 to 10.4) was the factor most strongly associated with burnout syndrome. CONCLUSIONS Burnout is more prevalent in anesthesiology since early 2020, with workplace factors of perceived support and staffing being the predominant associated variables. Interventions focused on the drivers of burnout are needed to improve well-being among U.S. attending anesthesiologists. EDITOR’S PERSPECTIVE
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Affiliation(s)
- Anoushka M. Afonso
- Department of Anesthesiology & Critical Care, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Joshua B. Cadwell
- Department of Anesthesiology & Critical Care, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Steven J. Staffa
- Department of Anesthesiology, Boston Children’s Hospital, Harvard Medical School, Boston, MA
| | - Jina L. Sinskey
- Department of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, CA
| | - Amy E. Vinson
- Department of Anesthesiology, Boston Children’s Hospital, Harvard Medical School, Boston, MA
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Zhong J, Bradford V, Fernandez AM, Infosino A, Soneru CN, Staffa SJ, Raman VT, Cravero J, Zurakowski D, Meier PM. Continued challenges in pediatric anesthesia during COVID-19 in 2022: An international survey from the pediatric anesthesia COVID-19 collaborative. Paediatr Anaesth 2023; 33:1020-1028. [PMID: 37732382 DOI: 10.1111/pan.14762] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 08/27/2023] [Accepted: 09/04/2023] [Indexed: 09/22/2023]
Abstract
INTRODUCTION This international survey explored the ongoing impact of COVID-19 on pediatric anesthesiology. It assessed COVID-19's impact on the practice of pediatric anesthesiology, staffing, job satisfaction, and retention at the beginning of 2022 and addressed what should be done to ameliorate COVID-19's impact and what initiatives hospitals had implemented. METHODS This survey focused on five major domains: equipment/medication, vaccination/testing, staffing, burnout, and economic repercussions. Pilot testing for questionnaire clarity was conducted by members of the Pediatric Anesthesia COVID-19 Collaborative. The survey was administered by e-mail to a representative of the 72 collaborative centers. Respondents were instructed to answer based on their institution's practice from February through April of 2022. Descriptive statistics with 95% confidence intervals are reported. RESULTS Seventy of seventy-two institutions participated in this survey (97% response rate). Fifty-nine (84%) were from the United States, and 11 (16%) included other countries. The majority experienced equipment (68%) and medication (60%) shortages. Many institutions reported staffing shortages in nursing (37%), perioperative staff (27%), and attending anesthesiologists (11%). Sixty-two institutions (89%) indicated burnout was a frequent topic of conversation among pediatric anesthesiologists. Forty-three institutions (61%) reported anesthesiologists leaving current practice and 37 (53%) early retirement. Twenty-eight institutions (40%) canceled elective cases. The major suggestions for improving job retention included improving financial compensation (76%), decreasing clinical time (67%), and increasing flexibility in scheduled clinical time (66%). Only a minority of institutions had implemented the following initiatives: improving financial compensation (19%), increased access to mental health/counseling services (30%), and assistance with child or elder care (7%). At the time of the survey, 34% of institutions had not made any changes. CONCLUSION Our study found that COVID-19 has continued to impact pediatric anesthesiology. There are major discrepancies between what anesthesiologists believe are important for job satisfaction and faculty retention compared to implemented initiatives. Data from this survey provide insight for institutions and departments for addressing these challenges.
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Affiliation(s)
- John Zhong
- Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Victoria Bradford
- Department of Anesthesiology, University of Kentucky, Lexington, Kentucky, USA
| | - Allison M Fernandez
- Department of Anesthesia, Pain and Perioperative Medicine, Johns Hopkins All Children's Hospital, St. Petersburg, Florida, USA
| | - Andrew Infosino
- Department of Anesthesia and Perioperative Care, University of California, San Francisco, California, USA
| | - Codruta N Soneru
- Department of Anesthesiology and Critical Care Medicine, University of New Mexico, Albuquerque, New Mexico, USA
| | - Steven J Staffa
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Vidya T Raman
- Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Joseph Cravero
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - David Zurakowski
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Petra M Meier
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Sanuki T, Kuroda H, Imaizumi U, Tsukimoto S, Katagiri N, Mizutani A, Ohnaka M, Kurata S, Kishimoto N, Kido K. The Impact of COVID-19 on Dental Anesthesiologists: An Online Survey of Board-Certified Dental Anesthesiology Specialists of the Japanese Dental Society of Anesthesiology. Anesth Prog 2023; 70:168-172. [PMID: 38221698 PMCID: PMC11088202 DOI: 10.2344/930714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 07/12/2023] [Indexed: 01/16/2024] Open
Abstract
OBJECTIVE The impact of the COVID-19 pandemic on dental anesthesiologists has not been examined. This study aimed to determine how the COVID-19 pandemic affected Japanese dental anesthesiologists' professional lives. METHODS An online questionnaire related to the effects of COVID-19 on dental anesthesiologists' professional lives was emailed to 351 board-certified dental anesthesiology specialists from the Japanese Dental Society of Anesthesiology. The endpoints of this study were changes in income and job satisfaction as a dental anesthesiologist from 2019 prior to the COVID-19 pandemic. RESULTS A total of 141 dental anesthesiologists participated in the survey. Most respondents reported no change in income relative to 2019 for 2020 or 2021. Significantly more dental anesthesiologists reported income decreases relative to 2019 for 2020 (39%) vs 2021 (21.3%; P = .001). Very few dental anesthesiologists reported income increases relative to 2019 for 2020 (2.1%) vs 2021 (15.6%; P < .001). Job satisfaction as a dental anesthesiologist remained unchanged for all 3 years. CONCLUSION Even though many Japanese dental anesthesiologist specialists lost income because of COVID-19, they maintained their job satisfaction.
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Affiliation(s)
- Takuro Sanuki
- Department of Dental Anesthesiology, Kanagawa Dental University, Yokosuka, Japan
| | - Hidetaka Kuroda
- Department of Dental Anesthesiology, Kanagawa Dental University, Yokosuka, Japan
| | - Uno Imaizumi
- Department of Dental Anesthesiology, Kanagawa Dental University, Yokosuka, Japan
| | - Shota Tsukimoto
- Department of Dental Anesthesiology, Kanagawa Dental University, Yokosuka, Japan
| | - Norika Katagiri
- Department of Dental Anesthesiology, Kanagawa Dental University, Yokosuka, Japan
| | - Ayako Mizutani
- Department of Dental Anesthesiology, Kanagawa Dental University, Yokosuka, Japan
| | - Mari Ohnaka
- Department of Dental Anesthesiology, Kanagawa Dental University, Yokosuka, Japan
- Department of Dental Anesthesiology, Nagasaki University, Nagasaki, Japan
| | - Shinji Kurata
- Department of Dental Anesthesiology, Nagasaki University, Nagasaki, Japan
| | - Naotaka Kishimoto
- Department of Dental Anesthesiology, Niigata University, Niigata, Japan
| | - Kanta Kido
- Department of Dental Anesthesiology, Kanagawa Dental University, Yokosuka, Japan
- Department of Dental Anesthesiology, Hokkaido University, Sapporo, Japan
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Janosy NR, DeBoer EM, Prager JD, Vogeli J, Wine T, Beacham AO. Social support moderates the relationship between burnout and job satisfaction in aerodigestive team members. Int J Pediatr Otorhinolaryngol 2023; 170:111602. [PMID: 37224738 DOI: 10.1016/j.ijporl.2023.111602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 05/16/2023] [Accepted: 05/18/2023] [Indexed: 05/26/2023]
Abstract
OBJECTIVES Burnout among healthcare workers is a public health crisis. Burnout is associated with elevated cynicism, emotional exhaustion, and low job satisfaction. Methods to combat burnout have been challenging to identify. Based on positive experiences of pediatric aerodigestive team members, we hypothesized that social support in multidisciplinary aerodigestive teams moderates the effects of burnout on job satisfaction. METHODS Using a survey of the Aerodigestive Society, members of Aerodigestive teams (N = 119) completed demographics, the Maslach Burnout Inventory, and measures of job satisfaction, emotional, and instrumental social support. In addition to assessing relationships between components of burnout and job satisfaction, six tests were conducted using PROCESS to ascertain the degree to which social support moderated these relationships. RESULTS Similar to US healthcare base rates, burnout scores in this sample suggest that a third-to-half felt Emotionally Exhausted and Burned Out from work "A few times a month"-to-"Every Day." Simultaneously, however, the majority in sample (60.6%) noted feeling that they "positively impact others' lives" with 33.3% endorsing "Every Day." Job satisfaction was strikingly high at 89%, with most reporting Aerodigestive team affiliation related to higher job satisfaction. Both Emotional and Instrumental social support moderated the effect of Cynicism and Emotional Exhaustion on Job Satisfaction, with higher Job Satisfaction scores in conditions of high support. CONCLUSIONS These results support the hypothesis that social support from a multidisciplinary aerodigestive team moderates the effect of burnout in its team members. Further work is needed to understand if membership in other interprofessional healthcare teams can help combat the negative effects of burnout.
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Affiliation(s)
- Norah R Janosy
- University of Colorado Department of Anesthesia, Aurora, CO, USA; Children's Hospital Colorado Aerodigestive Program, Aurora, CO, USA.
| | - Emily M DeBoer
- Children's Hospital Colorado Aerodigestive Program, Aurora, CO, USA; University of Colorado Department of Pediatrics, Aurora, CO, USA.
| | - Jeremy D Prager
- Children's Hospital Colorado Aerodigestive Program, Aurora, CO, USA; University of Colorado Department of Otolaryngology, Aurora, CO, USA.
| | - Jo Vogeli
- University of Colorado Department of Anesthesia, Aurora, CO, USA.
| | - Todd Wine
- Children's Hospital Colorado Aerodigestive Program, Aurora, CO, USA; University of Colorado Department of Otolaryngology, Aurora, CO, USA.
| | - Abbie O Beacham
- University of Louisville School of Dentistry, Louisville, KY, USA.
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Goodmanson MM, Latham GJ, Landsem LM, Ross FJ. The Year in Review: Anesthesia for Congenital Heart Disease 2022. Semin Cardiothorac Vasc Anesth 2023; 27:114-122. [PMID: 37125730 DOI: 10.1177/10892532231173801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
This review focuses on the literature published during the calendar year 2022 that is of interest to anesthesiologists taking care of children and adults with congenital heart disease (CHD). Four major themes are discussed: enhanced recovery after surgery(ERAS); diversity, equity, and inclusion; the state of pediatric cardiac anesthesiology as a subspecialty in the United States; and neuromonitoring for pediatric cardiac surgery.
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Affiliation(s)
- Matthew M Goodmanson
- Department of Anesthesiology & Pain Medicine, University of Washington School of Medicine, Seattle, WA, USA
- Department of Anesthesiology & Pain Medicine, Seattle Children's Hospital, Seattle, WA, USA
| | - Gregory J Latham
- Department of Anesthesiology & Pain Medicine, University of Washington School of Medicine, Seattle, WA, USA
- Department of Anesthesiology & Pain Medicine, Seattle Children's Hospital, Seattle, WA, USA
| | - Leah M Landsem
- Department of Anesthesiology & Pain Medicine, University of Washington School of Medicine, Seattle, WA, USA
- Department of Anesthesiology & Pain Medicine, Seattle Children's Hospital, Seattle, WA, USA
| | - Faith J Ross
- Department of Anesthesiology & Pain Medicine, University of Washington School of Medicine, Seattle, WA, USA
- Department of Anesthesiology & Pain Medicine, Seattle Children's Hospital, Seattle, WA, USA
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Abstract
Women represent approximately one-third of all anesthesiologists in the United States. Before the COVID-19 pandemic, research regarding gender bias in anesthesiology defined the scope of the problem. Unfortunately, the pandemic exposed and expanded the imbalances associated with gender, placing women anesthesiologists as both primary caregivers in the home and on the frontlines of health care. These systemic inequities exacerbated burnout in women anesthesiologists. Several initiatives that can improve well-being and the work culture for all anesthesiologists, including women, will also be discussed.
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Affiliation(s)
- Elizabeth B Malinzak
- Department of Anesthesiology, Duke University, DUMC 3094, 2301 Erwin Road, Durham, NC 27710, USA.
| | - Stephanie I Byerly
- Department of Anesthesiology and Pain Management, University of Texas Southwestern, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA.
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Abstract
PURPOSE OF REVIEW The purpose of this review is to provide the latest evidence for delivering safe and effective anesthesia care for pediatric patients with coronavirus disease 2019 (COVID-19) and to highlight continuing gaps in the literature. RECENT FINDINGS Safe and efficient care of pediatric patients with COVID-19 can be delivered with the proper planning, coordination, supplies, and staff preparation. From the start of the pandemic, pediatric anesthesiologists from around the world contributed important insights and shared experience as to how best to adapt anesthesia care for children with COVID-19 requiring general anesthesia and sedation. Although initial efforts focused on creating safe airway management processes, the role of anesthesiologists as perioperative leaders quickly extended to ensuring well-coordinated management of COVID-19 patients throughout the hospital for procedures, including preprocedure testing, patient transport, operating room setup, and ensuring the safety of staff. Several important areas remain not well studied including, the timing of rescheduling elective procedures following COVID-19 infection, the perioperative implications of re-infection, and future considerations of managing vaccinated children. SUMMARY Pediatric anesthesia care can be safely delivered to children with COVID-19 and after COVID-19 infection. More attention needs to be focused on the perioperative management of COVID-19 children in recovery requiring anesthesia.
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Affiliation(s)
- Jonathan M Tan
- Department of Anesthesiology Critical Care Medicine, Children's Hospital Los Angeles
- Department of Anesthesiology, Keck School of Medicine at the University of Southern California, Los Angeles, California, USA
| | - Nicola Disma
- Unit for Research & Innovation, Department of Pediatric Anesthesia, Istituto Giannina Gaslini, Genoa, Italy
| | - Clyde T Matava
- Department of Anesthesia and Pain Medicine, Hospital for Sick Children
- Department of Anesthesiology and Pain Medicine, Termerty Faculty of Medicine, University of Toronto, Ontario, Canada
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